Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science 2020)


Application Summary: Diploma in Nautical Science
 
Dossier ID: DNS2051754 Name: MURKUTE VIRAJ VINAYAK
  Address: PAN ATAI GULJARPURA ANJANGAON SURJI
Telephone No.: Mobile no: 9373068613
E-mail: virajmurkute521@gmail.com  
   
Application fee payment details:  
Payment Status: Paid Payment Mode: Online
Amount: ₹ 202.12 (Includes Convenience fee of ₹ 2.12 ) DD Number: -
Issuing Bank: - Transaction Id: 309495709
   
   
Declaration: We hereby declare that all the statements made in application form against Dossier ID DNS2051754 are true and correct.
Signature of Candidate Signature of Parent/Guardian
   
   

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Date ________________ Date ________________
 
Please quote your dossier id and full name for any future correspondence
Please keep a copy of the form for your reference for communicating with the Institute

Note: Please remember to login and fill in your 12th std PCM marks when they are published & IMUCET Application number in order to complete your application form.

Tolani Maritime Institute
Induri,Talegaon Dabhade, Pune - 410507
Tel.: 02114-669600/1, E-mail: info@tmi.tolani.edu, Web: www.tolani.edu
(New Admission Diploma in Nautical Science )

APPLICATION FOR ADMISSION - 2020

 
  Dossier ID: DNS2051754
 
Applicant's Personal Information:
 
Full Name as on Class XII Marksheet/Pass Certificate: MURKUTE VIRAJ VINAYAK
Mother's Name: VANDANA
Gender (M/F): Male Marital Status (Single/Married): Single
Date of Birth (DD/MM/YY): 30 Jul 2002 Nationality: INDIAN
Place of Birth: ACHALPUR Personal Identification Mark: MOLE ON CHEST
Blood Group: A + Address for Communication: PAN ATAI GULJARPURA ANJANGAON SURJI
State: Maharashtra Country: India
Pin: 444705 City/District: AMRAVATI
Mobile no: 9373068613 Telephone No. with STD code:
Aadhar Card No:838271345093 E-mail: virajmurkute521@gmail.com
 
Guardian's Particulars:
 
Name of Parent/Guardian: VINAYAK MURKUTE Relationship with candidate: FATHER
Parents Date of Birth: 22 Nov 1972 Parent's/Guardian's Occupation/Designation: FARMER
   
Office Address:
   
Address: GULJARPURA PAN ATAI ANJANGAON SURJI
Country: India State: Maharashtra
City/District: AMRAVATI Pin: 444705
Tel: Mobile no.: 9922493405
Fax: Email: virajmurkute520@gmail.com
 

Education and Academic Record :


Class X: - Class XII: -
Year of Passing: 2018 Year of Passing: 2020
Board: Maharashtra Board: Maharashtra
School: SITABAI SANGAI HIGHSCHOOL ANJANGAON SURJI School: SITARAMJI GANORKAR PATHROT
City: ANJANGAON SURJI City: PATHROT
English %: 76 Board Roll No./Seat No.:
Aggregate Percentage: 82 School/College Code:
  Centre code:
  Address of School/College: SITARAMJI GANORKAR PATHROT ANJANGAON SURJI DIST AMRAVATI 444705
  Pin: 444705
  Contact Nos:
  Email: virajmurkute520@gmail.com
  Aggregate Percentage:
   
Details of Marks Secured in (10+2) Examination -

SUBJECTS MAXIMUM MARKS
MARKS SECURED PERCENTAGE (%)
Physics 100
Chemistry 100
Mathematics 100
Physics, Chemistry & Mathematics combined Percentage:
English 100
   
IMU CET Application Number:  
 
How do you intend spending your time after completing class XII Final exams and before joining college ?: typing
Why do you wish to join TMI?: BEST FUTURE
What are your hobbies?: BATMINTION
What are your strengths?: STAMINA
What are your weaknesses?: SADNESS
How do you intend to meet the expenses of this program?: Own Resources
 
Review you documents:
Birth certificate DGS Approved Medical Fitness Certificate not uploaded Class X marksheet School leaving certificate not uploaded Class XII admit card not uploaded Class XII marksheet not uploaded
 
Declaration

I hereby declare that all the statements made above are true and correct.

Signature of Candidate

 

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Date ________________

 
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